Individual
SUZANNE M. BERTOLLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., MPH
Contact information
Practice address
777 GLADES RD # BC71, BOCA RATON, FL 33431-6424
(561) 297-3622
Mailing address
777 GLADES RD # BC-71, BOCA RATON, FL 33431-6424
(561) 297-3622
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
30296
SC
207P00000X
Emergency Medicine Physician
9700023
NC
207P00000X
Emergency Medicine Physician
ME144621
FL
2083P0901X
Public Health & General Preventive Medicine Physician
30296
SC
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
ME144621
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
79-10976
—
NC
01
—
AA22522353
MEDICARE PTAN
SC
05
—
N00023
—
SC
Enumeration date
05/08/2006
Last updated
06/28/2021
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